Single payer; single provider

Hello. Dr. Keith Smith with you – Surgery Center of Oklahoma. Thank you for joining us in this video blog series.

I had the privilege to travel to England to see a relative who is living over there. While I was there, I made a point of visiting a clinic – this utopia of the National Health Service. Many people who clamor for a single-payer system, that’s how they would describe it.

It was anything but a utopia. If anything, it looked like something out of a third world. It occurred to me, while I was looking around, that single-payer really and inexorably leads to single provider. Basically, to say single-payer, means single provider. Because every single thing, every single person, they look the same. They act the same. There are no incentives to be better. There are no competitive incentives to be better and draw patients for having been better.

Single payer is really about removing all choices. And without choices, life is very different. Without a competing healthcare facility across the street, then a facility that has the monopoly will treat patients exactly as you would think. They’re going to treat them as if they’re coming back because actually they have no other choices.

I saw this first-hand and it is not the utopia that many of you might think single-payer is. It is a disaster. And it is the absence of the free market and competitive pressures that have led to the National Health Service being what it is.

Interestingly, there is a very strong movement in England and other countries that have gone down this socialist medicine path, to privatize. Of course here in the United States, we seem to be drifting the other direction. Those that have been socialized in their medical approaches are definitely seeing that it simply doesn’t work and they’re making efforts to get things privatized. Even our neighbors to the north, Canada, are kicking the tires of some free-market and privatization solutions.

I wanted to pass this on, along with what I saw, and also get everybody thinking that really, single-payer is about not having choices and it really means single provider.